Adenopathy: how to explain the abnormal swelling of the lymph nodes?

Lymphadenopathy means unusual swelling of the lymph nodes. This phenomenon may be linked to a temporary benign infection, but may also have a cancerous origin. How to be sure? What steps to adopt?

Definition: what is lymphadenopathy? Is it necessarily cancer?

This medical term refers to an abnormality of the lymph nodes. We’re talking aboutadenomegaly. Said lymph nodes are abnormally swollen, which testifies to an aggression of the organism. This situation is cause for concern, because the lymph nodes play a key role in the immune system : they are in particular the seat of the proliferation of lymphocytes, immune cells whose purpose is to eliminate pathogenic agents.

What is polyadenopathy?

Our body has many ganglia distributed at different levels. Lymphadenopathy may involve only one type of lymph node (isolated lymphadenopathy), or multiple nodes simultaneously. In this case, we speak of polyadenopathy, or generalized adenopathy.

Deep or superficial adenopathy?

We distinguish superficial adenopathieslocated at the nape of the neck, neck, armpits or groin and detectable on palpation.

And deep adenopathieslocated in the chest and abdomen, which can only be detected through certain medical examinations, such as an X-ray, ultrasound, CT scan, or MRI.

Cervical, axillary, inguinal, mediastinal, hilar, occipital adenopathy…

Lymphadenopathy can be classified according to the type of lymph nodes involved, including:

  • Inguinal lymphadenopathy – which designate an increase in the volume of one or more lymph nodes in the groin and may be related to an infection of the lower limbs, genitals or anus.
  • Hilar lymphadenopathy – which designate an increase in the volume of one or more lymph nodes in the large bronchi of each lung and may be linked to a pulmonary infection, sarcoidosis or lung cancer.
  • Occipital lymphadenopathy – which designate an increase in the volume of one or more lymph nodes in the occiput (the rear base of the skull) and may be linked to an infection of the scalp or of the entire ENT sphere.
  • Axillary lymphadenopathy – which designate an increase in the volume of one or more lymph nodes in the armpits and may be related to an infection of the upper limbs.
  • Mediastinal lymphadenopathy – which designate an increase in the volume of one or more lymph nodes in the middle region of the thoracic cage (mediastinum) and may have an infectious, dysimmune (sarcoidosis) or tumoral origin (Hodgkin’s lymphoma, lung cancer).
  • Cervical lymphadenopathy – which designate an increase in the volume of one or more lymph nodes in the neck and are generally linked to an infection of the ENT sphere.

The symptoms of lymphadenopathy are numerous and extremely varied. They depend in particular on the type of lymphadenopathy in question and the cause of the swelling of the lymph nodes.

Ldeep adenopathies are usually not betrayed by any symptoms. When they are too large, however, they can result in:

Superficial adenopathies, they are much more palpable. The lymph nodes may be warm, hard and painful (or not).

  • When they are hot and painful, superficial lymphadenopathy is often linked to inflammation or an infection of bacterial, viral, or parasitic origin (cat-scratch disease, mononucleosis, etc.).
  • When hard and painless, superficial lymphadenopathy may be a sign of breast cancer, blood disease (Hodgkin’s lymphoma, leukemia, Hodgkin’s disease), sarcoidosis, tuberculosisor an autoimmune disease.

It also happens that swollen glands are accompanied by an inflammatory reaction. We therefore speak of inflammatory adenopathy, characterized by a rise in fever.

What are the main causes of adenopathy?

Infectious adenopathies can be linked to:

  • a staphylococcal or streptococcal infection;
  • cat scratch disease;
  • tularemia;
  • a sexually transmitted disease (STD) such as syphilis;
  • tuberculosis ;
  • toxoplasmosis;
  • infectious mononucleosis;
  • etc

Cancerous adenopathies can be linked to:

  • cancer of the lymphatic system (Hodgkin lymphoma);
  • lymph node metastases, in other words secondary tumors which can result from cancers in the ENT sphere, tongue, thyroid, abdomen, pelvis, breast, external genitalia, anal canal or skin.

Swollen ganglion (adenomegaly): when, and who, to consult?

Consult your doctor as soon as you discover a visible/palpable lump or mass. Especially if it lasts over time. A clinical examination supplemented by specific examinations makes it possible to establish a clear diagnosis. Your doctor may be able to refer you to a specialist: an infectious disease specialist, an oncologist, an internist, a hematologist, etc.

Diagnosis: when is a lymph node considered worrying?

As noted above, the diagnosis of lymphadenopathy is based on a clinical examination that takes into account the size and location of the lymph nodes.

If the origin of the masses appears obvious, no further examination will be necessary. This is generally the case with superficial adenopathies.

On the other hand, when the origin of the masses seems too difficult to discern, the doctor can prescribe:

  • a blood test (or other microbiological examinations);
  • a to scan (a computed tomography),
  • a lymph node biopsywhich involves removing and analyzing a lymph node,
  • a complete blood countwhich can be put in place to confirm infectious adenopathy,
  • a lymph node puncture (sampling from the lymph nodes using a needle),
  • or some imaging examsespecially in case of deep adenopathies.

After the discovery of lymphadenopathy, if its cause seems obvious, its management consists of treat said cause. There are therefore many treatment options.

If it is a bacterial infection (pharyngitis, otitis, dental abscess, etc.), the doctor prescribes antibiotics. Thus, the nodes will return to their initial size.

If it is an inflammatory adenopathy, he prescribes a anti-inflammatory treatment.

If it’s cancer, he opts for surgery, radiation therapy or chemotherapyor even for a bone marrow transplant in case of leukemia.

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